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Misdiagnosis of loin pain hematuria syndrome as a somatization disorder

Published online by Cambridge University Press:  23 March 2020

L. De Jonge ,
S. Petrykiv ,
J. Fennema  and
M. Arts
L. De Jonge
Affiliation:
Leonardo scientific research institute, geriatric psychiatry, Bergen op Zoom, The Netherlands
S. Petrykiv
Affiliation:
University of Groningen–university medical center Groningen, department of clinical pharmacy and pharmacology, Groningen, The Netherlands
J. Fennema
Affiliation:
GGZ Friesland, geriatric psychiatry, Leeuwarden, The Netherlands
M. Arts
Affiliation:
University of Groningen–university medical center groningen, department of old age psychiatry, Groningen, The Netherlands

Abstract

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Introduction

Loin pain hematuria syndrome (LPHS) is a rare kidney disease with a prevalence of −0.012%. Its clinical features include periods of severe uni-or bilateral lion pain, accompanied by (microscopic) hematuria. It is often misdiagnosed as a psychiatric condition, particularly under the heading of a somatization disorder.

Objectives

We describe the case of a patient who developed depressive symptoms after decades of suffering from severe intermittent bilateral loin pain.

Aims

To report a case-study, describing LPHS as a cause of severe chronic pain and persistent depressive symptoms.

Methods

A case-study is presented and discussed, followed by a literature review.

Results

A 55-year-female was referred to a psychiatrist for her depressive symptoms and persistent periods of severe unilateral or bilateral lion pain and intermittent hematuria for over 25 years. There she was diagnosed with a depression and somatization disorder. She received amitriptyline for many years, without any effect. Finally, the patient opted for a second opinion in an academic hospital in Belgium where it was quickly discovered. After surgery, including renal denervation and kidney autotransplantation, her somatic problems and depressive mood disappeared.

Conclusions

The awareness of LPHS is still very limited in medicine. This may lead to incorrect diagnoses, including psychiatric disorders such as somatization disorder. More awareness could lead to earlier diagnosis and prevent the consequences of severe debilitating pain.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Consultation liaison psychiatry and psychosomatics
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S491
Copyright
Copyright © European Psychiatric Association 2017
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